NCCN Guidelines for Patients® | Pancreatic Cancer - page 57

55
NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
5.3
Treatment guide
Borderline resectable pancreatic cancer
might make surgery more difficult. NCCN experts
recommend that surgery should be done at a hospital
that does more than 15 pancreatic cancer surgeries
each year. Hospitals that perform many pancreatic
surgeries often have better results.
At the time of surgery your doctor may find that the
cancer has spread too far to all be removed. In this
case, surgery cannot be completed. At this time, if
you have jaundice, your doctor may give treatments
for symptoms caused by the cancer. This is called
supportive care. Your doctor will place a stent in the
blocked bile duct or do a biliary bypass to relieve
jaundice. You may have a duodenal bypass to relieve
or prevent a blocked stomach. Your doctor may also
do a nerve block to relieve severe pain. Read Part 4
on page 36 for details on each of these supportive
care treatments.
If the follow-up tests showed signs of
cancer growth or spread,
then surgery is not
recommended. In this case, the next treatment
recommended depends on how far the cancer has
spread. Cancer that has spread only to blood vessels
or other tissues near the pancreas is called locally
advanced unresectable. Cancer that has spread to
sites far away from the pancreas is called metastatic.
Next steps:
If the cancer was removed by surgery,
see Chart 5.3.4 for adjuvant treatment
recommendations. If the cancer
spread before surgery or if it couldn’t
be removed by surgery, see Part 5.4
for locally advanced unresectable
cancer or Part 5.5 for metastatic cancer
treatment recommendations.
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